[Gastric cancer. New frontiers in surgical therapy]

The authors compare their experience in the surgical treatment of gastric carcinoma with the literature and point out that therapeutic value of a wide gastric resection and adequate lymphadenectomy can improve a 5-year survival without increasing mortality and morbidity. In an 8-year experience in 258 patients with gastric carcinoma, 249 underwent operation, 139 with curative intention. Wide gastric resection proved to be effective and safer than elective total gastrectomy, and D2-lymphadenectomy showed the same morbidity of D1 and seems to offer a better 5-year survival. Extended resections for gastric cancer, that result in simultaneous pancreatectomy, splenectomy, hesophagectomy, resection of the colon and hepatectomy, do not show significant improvement of the survival.